Acute delirium as an initial manifestation of COVID-19 patients with acute ischemic stroke: Report on two cases.
J Formos Med Assoc
; 121(8): 1605-1609, 2022 Aug.
Article
in English
| MEDLINE | ID: covidwho-1739928
ABSTRACT
Psychiatric and neurological complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are common. Psychiatric symptoms are so common that they are easily misinterpreted as an affective disorder induced by SARSCoV-2 infection. However, psychiatric symptoms, such as acute delirium, though rarely seen, can be the initial manifestations of acute ischemic stroke (AIS). These psychiatric symptoms may confuse the diagnosis of acute stroke, which needs correct and timely management. We report two hospitalized cases with SARS-CoV-2 infection and elevated serum D-dimer levels having acute delirium as the initial manifestation of AIS. The diagnostic processes were challenging and time-consuming, so reperfusion therapy could not be given in the therapeutic time window. The diagnoses of AIS were finally made by brain magnetic resonance imaging which showed diffusion restriction at the right middle cerebral artery territory in both cases. Features of psychiatric complications and stroke in coronavirus disease 2019 (COVID-19) patients are reviewed. For the hospitalized COVID-19 patients with elevated levels of serum Ddimer and acute delirium, acute stroke with neuropsychiatric manifestations should beconsidered.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Stroke
/
Delirium
/
Ischemic Stroke
/
COVID-19
Type of study:
Case report
/
Diagnostic study
Topics:
Long Covid
Limits:
Humans
Language:
English
Journal:
J Formos Med Assoc
Journal subject:
Medicine
Year:
2022
Document Type:
Article
Affiliation country:
J.jfma.2022.01.025
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